More than three decades after links emerged between Sanofi's epilepsy drug valproate and birth defects, many pregnant women remain unaware of the risks, patients, doctors and researchers said on Tuesday. Prescribed globally for epilepsy and bipolar disorders - and in some cases migraines - valproate is included in the World's Health Organisation list of essential medicines. "Measures have been taken ... but these have largely been tick-box exercises with little regard for delivering real change," Karen Keely, from Irish patient support group Fetal Anti-Convulsant Syndrome, told a public hearing in London hosted by the European Medicines Agency (EMA).